The influence of Arabian physicians rested chiefly upon their use of drugs rather than upon anatomical knowledge. Like the mediaeval Christians, they looked with horror on dissection of the human body; yet there were always among them investigators who turned constantly to nature herself for hidden truths, and were ready to uphold the superiority of actual observation to mere reading. Thus the physician Abd el-Letif, while in Egypt, made careful studies of a mound of bones containing more than twenty thousand skeletons. While examining these bones he discovered that the lower jaw consists of a single bone, not of two, as had been taught by Galen. He also discovered several other important mistakes in Galenic anatomy, and was so impressed with his discoveries that he contemplated writing a work on anatomy which should correct the great classical authority's mistakes.

It was the Arabs who invented the apothecary, and their pharmacopoeia, issued from the hospital at Gondisapor, and elaborated from time to time, formed the basis for Western pharmacopoeias. Just how many drugs originated with them, and how many were borrowed from the Hindoos, Jews, Syrians, and Persians, cannot be determined. It is certain, however, that through them various new and useful drugs, such as senna, aconite, rhubarb, camphor, and mercury, were handed down through the Middle Ages, and that they are responsible for the introduction of alcohol in the field of therapeutics.

In mediaeval Europe, Arabian science came to be regarded with superstitious awe, and the works of certain Arabian physicians were exalted to a position above all the ancient writers. In modern times, however, there has been a reaction and a tendency to depreciation of their work. By some they are held to be mere copyists or translators of Greek books, and in no sense original investigators in medicine. Yet there can be little doubt that while the Arabians did copy and translate freely, they also originated and added considerably to medical knowledge. It is certain that in the time when Christian monarchs in western Europe were paying little attention to science or education, the caliphs and vizirs were encouraging physicians and philosophers, building schools, and erecting libraries and hospitals. They made at least a creditable effort to uphold and advance upon the scientific standards of an earlier age.

The first distinguished Arabian physician was Harets ben Kaladah, who received his education in the Nestonian school at Gondisapor, about the beginning of the seventh century. Notwithstanding the fact that Harets was a Christian, he was chosen by Mohammed as his chief medical adviser, and recommended as such to his successor, the Caliph Abu Bekr. Thus, at the very outset, the science of medicine was divorced from religion among the Arabians; for if the prophet himself could employ the services of an unbeliever, surely others might follow his example. And that this example was followed is shown in the fact that many Christian physicians were raised to honorable positions by succeeding generations of Arabian monarchs. This broad-minded view of medicine taken by the Arabs undoubtedly assisted as much as any one single factor in upbuilding the science, just as the narrow and superstitious view taken by Western nations helped to destroy it.

The education of the Arabians made it natural for them to associate medicine with the natural sciences, rather than with religion. An Arabian savant was supposed to be equally well educated in philosophy, jurisprudence, theology, mathematics, and medicine, and to practise law, theology, and medicine with equal skill upon occasion. It is easy to understand, therefore, why these religious fanatics were willing to employ unbelieving physicians, and their physicians themselves to turn to the scientific works of Hippocrates and Galen for medical instruction, rather than to religious works. Even Mohammed himself professed some knowledge of medicine, and often relied upon this knowledge in treating ailments rather than upon prayers or incantations. He is said, for example, to have recommended and applied the cautery in the case of a friend who, when suffering from angina, had sought his aid.

The list of eminent Arabian physicians is too long to be given here, but some of them are of such importance in their influence upon later medicine that they cannot be entirely ignored. One of the first of these was Honain ben Isaac (809-873 A.D.), a Christian Arab of Bagdad. He made translations of the works of Hippocrates, and practised the art along the lines indicated by his teachings and those of Galen. He is considered the greatest translator of the ninth century and one of the greatest philosophers of that period.

Another great Arabian physician, whose work was just beginning as Honain's was drawing to a close, was Rhazes (850-923 A.D.), who during his life was no less noted as a philosopher and musician than as a physician. He continued the work of Honain, and advanced therapeutics by introducing more extensive use of chemical remedies, such as mercurial ointments, sulphuric acid, and aqua vitae. He is also credited with being the first physician to describe small-pox and measles accurately.

While Rhazes was still alive another Arabian, Haly Abbas (died about 994), was writing his famous encyclopaedia of medicine, called The Royal Book. But the names of all these great physicians have been considerably obscured by the reputation of Avicenna (980-1037), the Arabian "Prince of Physicians," the greatest name in Arabic medicine, and one of the most remarkable men in history. Leclerc says that "he was perhaps never surpassed by any man in brilliancy of intellect and indefatigable activity." His career was a most varied one. He was at all times a boisterous reveller, but whether flaunting gayly among the guests of an emir or biding in some obscure apothecary cellar, his work of philosophical writing was carried on steadily. When a friendly emir was in power, he taught and wrote and caroused at court; but between times, when some unfriendly ruler was supreme, he was hiding away obscurely, still pouring out his great mass of manuscripts. In this way his entire life was spent.

By his extensive writings he revived and kept alive the best of the teachings of the Greek physicians, adding to them such observations as he had made in anatomy, physiology, and materia medica. Among his discoveries is that of the contagiousness of pulmonary tuberculosis. His works for several centuries continued to be looked upon as the highest standard by physicians, and he should undoubtedly be credited with having at least retarded the decline of mediaeval medicine.

But it was not the Eastern Arabs alone who were active in the field of medicine. Cordova, the capital of the western caliphate, became also a great centre of learning and produced several great physicians. One of these, Albucasis (died in 1013 A.D.), is credited with having published the first illustrated work on surgery, this book being remarkable in still another way, in that it was also the first book, since classical times, written from the practical experience of the physician, and not a mere compilation of ancient authors. A century after Albucasis came the great physician Avenzoar (1113-1196), with whom he divides about equally the medical honors of the western caliphate. Among Avenzoar's discoveries was that of the cause of "itch" - a little parasite, "so small that he is hardly visible." The discovery of the cause of this common disease seems of minor importance now, but it is of interest in medical history because, had Avenzoar's discovery been remembered a hundred years ago, "itch struck in" could hardly have been considered the cause of three-fourths of all diseases, as it was by the famous Hahnemann.

The illustrious pupil of Avenzoar, Averrhoes, who died in 1198 A.D., was the last of the great Arabian physicians who, by rational conception of medicine, attempted to stem the flood of superstition that was overwhelming medicine. For a time he succeeded; but at last the Moslem theologians prevailed, and he was degraded and banished to a town inhabited only by the despised Jews.

Arabian hospitals.
To early Christians belong the credit of having established the first charitable institutions for caring for the sick; but their efforts were soon eclipsed by both Eastern and Western Mohammedans. As early as the eighth century the Arabs had begun building hospitals, but the flourishing time of hospital building seems to have begun early in the tenth century. Lady Seidel, in 918 A.D., opened a hospital at Bagdad, endowed with an amount corresponding to about three hundred pounds sterling a month. Other similar hospitals were erected in the years immediately following, and in 977 the Emir Adad-adaula established an enormous institution with a staff of twenty-four medical officers. The great physician Rhazes is said to have selected the site for one of these hospitals by hanging pieces of meat in various places about the city, selecting the site near the place at which putrefaction was slowest in making its appearance. By the middle of the twelfth century there were something like sixty medical institutions in Bagdad alone, and these institutions were free to all patients and supported by official charity.

The Emir Nureddin, about the year 1160, founded a great hospital at Damascus, as a thank-offering for his victories over the Crusaders. This great institution completely overshadowed all the earlier Moslem hospitals in size and in the completeness of its equipment. It was furnished with facilities for teaching, and was conducted for several centuries in a lavish manner, regardless of expense. But little over a century after its foundation the fame of its methods of treatment led to the establishment of a larger and still more luxurious institution - the Mansuri hospital at Cairo. It seems that a certain sultan, having been cured by medicines from the Damascene hospital, determined to build one of his own at Cairo which should eclipse even the great Damascene institution.

In a single year (1283-1284) this hospital was begun and completed. No efforts were spared in hurrying on the good work, and no one was exempt from performing labor on the building if he chanced to pass one of the adjoining streets. It was the order of the sultan that any person passing near could be impressed into the work, and this order was carried out to the letter, noblemen and beggars alike being forced to lend a hand. Very naturally, the adjacent thoroughfares became unpopular and practically deserted, but still the holy work progressed rapidly and was shortly completed.

This immense structure is said to have contained four courts, each having a fountain in the centre; lecture-halls, wards for isolating certain diseases, and a department that corresponded to the modern hospital's "out-patient" department. The yearly endowment amounted to something like the equivalent of one hundred and twenty-five thousand dollars. A novel feature was a hall where musicians played day and night, and another where story-tellers were employed, so that persons troubled with insomnia were amused and melancholiacs cheered. Those of a religious turn of mind could listen to readings of the Koran, conducted continuously by a staff of some fifty chaplains. Each patient on leaving the hospital received some gold pieces, that he need not be obliged to attempt hard labor at once.

In considering the astonishing tales of these sumptuous Arabian institutions, it should be borne in mind that our accounts of them are, for the most part, from Mohammedan sources. Nevertheless, there can be little question that they were enormous institutions, far surpassing any similar institutions in western Europe. The so-called hospitals in the West were, at this time, branches of monasteries under supervision of the monks, and did not compare favorably with the Arabian hospitals.

But while the medical science of the Mohammedans greatly overshadowed that of the Christians during this period, it did not completely obliterate it. About the year 1000 A.D. came into prominence the Christian medical school at Salerno, situated on the Italian coast, some thirty miles southeast of Naples. Just how long this school had been in existence, or by whom it was founded, cannot be determined, but its period of greatest influence was the eleventh, twelfth, and thirteenth centuries. The members of this school gradually adopted Arabic medicine, making use of many drugs from the Arabic pharmacopoeia, and this formed one of the stepping-stones to the introduction of Arabian medicine all through western Europe.

It was not the adoption of Arabian medicines, however, that has made the school at Salerno famous both in rhyme and prose, but rather the fact that women there practised the healing art. Greatest among them was Trotula, who lived in the eleventh century, and whose learning is reputed to have equalled that of the greatest physicians of the day. She is accredited with a work on Diseases of Women, still extant, and many of her writings on general medical subjects were quoted through two succeeding centuries. If we may judge from these writings, she seemed to have had many excellent ideas as to the proper methods of treating diseases, but it is difficult to determine just which of the writings credited to her are in reality hers. Indeed, the uncertainty is even greater than this implies, for, according to some writers, "Trotula" is merely the title of a book. Such an authority as Malgaigne, however, believed that such a woman existed, and that the works accredited to her are authentic. The truth of the matter may perhaps never be fully established, but this at least is certain - the tradition in regard to Trotula could never have arisen had not women held a far different position among the Arabians of this period from that accorded them in contemporary Christendom.